What does it mean to have a head concussion? Much has been written in recent years about the short- and long-term consequences of concussions sustained in sports, combat, and accidents. However, there appear to be no steadfast rules guiding the definition of concussion: the characteristics associated with this type of traumatic head injury have shifted over time and across medical disciplines. Within the context of a larger longitudinal investigation of the biomechanical factors in play that correlate with concussions in collegiate helmeted contact sports, researchers in New England and Virginia used data they obtained to investigate which signs, symptoms, and clinical histories were used by athletic trainers to define concussion in individual players. The investigators found that a heterogeneous collection of acute clinical characteristics currently exists for those events diagnosed as concussion in college athletes engaged in contact sports. Together with her colleagues, Dr. Duhaime, Director of Pediatric Neurosurgery and of Neurotrauma and Intensive Care in the Neurosurgical Service of Massachusetts General Hospital, examined concussions diagnosed in athletes participating in helmeted contact sports (football and ice hockey) at three universities: Dartmouth, Brown, and Virginia Tech. Both male and female athletes participated in the study. The students' helmets were outfitted with Head Impact Telemetry (HIT) System™ technology to record and measure peak linear and angular acceleration of impacts. The helmets were worn during practice sessions and games throughout two to four seasons. The investigators did not attempt to influence how trainers and team medical personnel defined concussion operationally, but instead relied on the clinical characteristics deemed indicative of concussion by the universities' athletic departments. More than 486,000 head impacts were recorded in 450 athletes, and concussion was diagnosed in 44 of these athletes (48 concussions) by team medical staff. Unlike concussions more often diagnosed in emergency departments, where a single, identified contact event leads to a loss of consciousness or other clear alteration in consciousness, most diagnoses in this sports setting were based on self-reports by athletes, and only a few were based on changes in athletes' clinical conditions that were observed by others. Thirty-one concussions could be directly associated with a specific impact, whereas a relationship with a specific impact could not be verified in the other cases of concussion. Only half of the athletes noted symptoms immediately after a contact event; in many athletes, the onset of symptoms was delayed. The most common reported symptoms were mental clouding, headache, and dizziness; only one case involved a loss of consciousness. The diagnosis of concussion by trainers often occurred in an even more delayed fashion: the diagnosis was made immediately after the event in 6 cases and at a later time in the other cases (median 17 hours postinjury). In general, the mean peak linear and angular accelerations for specific impact events that could be directly linked to concussions tended be in the high percentiles for the sports examined; however, there was considerable variability in the ranges of these measurements (mean peak linear acceleration 86.1 ± 42.6 g [range 16.5.9 g], mean peak angular acceleration 3620 ± 2,166 rads/sec2 [range 183,589 rads/sec2]). The variety of signs and symptoms, the imprecise timing of symptom appearance and relationship to a specific contact event, the lack of externally observed findings, and the broad ranges of the linear and angular accelerations of the impacts that coalesce in a diagnosis of concussion in college sports make it difficult to identify predictors of acute, intermediate, and long-term risks of adverse consequences resulting from sports-related head impacts. By describing the heterogeneity inherent in diagnoses of concussion as a "concussion spectrum," the authors point out the need for renewed efforts to determine which factors -- clinical, mechanical, genetic, or others -- influence outcomes in patients with single as well as repeated head impacts. The authors point out that while a clinical diagnosis is important to protect players from additional and potentially more serious consequences, it is also possible that athletes who do not receive the diagnosis of "concussion" may be at similar risk. Likewise, it is possible that some players who receive a diagnosis of concussion do not fall into a high-risk category for specific consequences. The authors note that there is still much to be learned, and that the terminology in use can sometimes oversimplify a more complex set of processes that still need to be teased apart. In their response to an accompanying editorial, they state, "By carefully characterizing exactly what we are talking about and by continued investigation, which will take more time ... , neurosurgeons and others will be best positioned to offer effective treatments and to advocate knowledgeably for appropriate injury-prevention strategies." Source: ScienceDaily

KANSAS CITY, Mo. -- The National Operating Committee on Standards for Athletic Equipment (NOCSAE) issued a warning to athletes and parents of athletes to thoroughly understand the extent of protection provided by – or not provided by – athletic equipment worn while playing sports. This warning follows claims made by several companies that products such as head bands, supplements or mouth guards reduce the incident of concussion. NOCSAE issued the warning at the onset of its summer meeting held this year in Kansas City. NOCSAE is an independent organization with the dual purpose of setting standards for the performance of athletic equipment and funding research necessary to advance the science of sports. Through NOCSAE's independent process, physicians, academic researchers, coaches, trainers and manufacturers come together to establish standards based on accepted science and reliable data. "Parents, athletes and coaches are becoming more informed about concussions, and this increased awareness is vitally important to advancing athlete safety. But it also creates a demand for quick solutions. Unfortunately there are quick solutions offered for sale which have neither scientific nor medical support that validate their claims to prevent or reduce concussions," said Mike Oliver, NOCSAE executive director. "Any device or supplement promoted as being able to prevent, diagnose or cure a concussion must be supported by scientific data and peer-reviewed research. Currently there is no definitive scientific research linking mouth guards, head bands, supplements or other specialty products to a reduction in concussion risk or severity. For companies to suggest otherwise misleads athletes, parents and coaches into a dangerous false sense of protection against concussion. NOCSAE warns athletes and parents of athletes to get the facts about sports equipment and concussion protection and not rely solely on marketing and promotional materials when making equipment decisions." NOCSAE does not maintain any standards for such products, and, therefore, no such products can be claimed as meeting the NOCSAE standards. While protective equipment certified to the NOCSAE standard play an incredibly important role in protecting athletes on the field of play, they should be not the primary approach to protecting against concussion. Learning to avoid unnecessary head impacts, reporting concussion symptoms to a coach or parent and following trained medical management decisions about when a concussed athlete can return to play are far more likely to prevent a concussion or reduce the chance of chronic problems that may be related to untreated concussions. For more information, please visit www.nocsae.org. About NOCSAE NOCSAE, the Nhttps:// Operating Committee on Standards for Athletic Equipment, is an independent and nonprofit standard-setting body with the sole mission to enhance athletic safety through scientific research and the creation of performance standards for protective equipment. Formed in 1969, NOCSAE is a leading force in the effort to improve athletic equipment and, as a result, reduce injuries. NOCSAE efforts include the development of performance and test standards for football helmets and facemasks, baseball and softball batters and catchers helmets, baseballs and softballs, ice hockey helmets, soccer shin guards, lacrosse helmets and facemasks and polo helmets. NOCSAE is comprised of representatives from a number of groups which have an interest in athletic equipment – including manufacturers, reconditioners, athletic trainers, coaches, equipment managers, sports medicine and consumer organizations. These diverse interests have joined forces in an attempt to arrive at a common goal of reducing sports-related injuries. NOCSAE is a nonprofit, charitable organization supported by individuals and organizations with an interest in athletics. SOURCE: National Operhttps://ommittee on Standards for Athletic Equipment (NOCSAE) Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org Back to top RELATED LINKShttps://www.nocsae.org Source: PR Newswire (https://s.tt/1ezQW)

The Dynavision D2 ™ is an FDA cleared medical device with a long history concerning sports performance enhancement and an even longer history concerning neuro visual rehabilitation of stroke and brain injured patients. Physical medicine rehabilitation practitioners have used it to train brain injured patients to improve hand eye coordination since the 1980s. With a pedigree from the neuroscience community concerning rehab and from the sports community for improving performance it was a logical fit that the D2 ™ be applied to the management of the athlete with a concussion. The Dynavision D2 ™ is a light board with 64 lights mounted in a board along with a small screen. The primary task is to hit the red or green lights. It assesses speed and coordination. When the computer screen and lights are used together there are numerous tasks the athlete can be asked to do. Several universities and professional sports organizations have adopted the Dynavision D2 ™ as part of the concussion management program, and for good reason. The Dynavision D2 ™ can be used as part of baseline testing. The results of the baseline tests are used for comparisons should a concussion occur. These same athletes may also train their eye hand coordination using the Dynavision D2 ™ for performance enhancement. This means the device is familiar to them and true baseline and performance parameters can be obtained. After a concussion, the Dynavision D2 ™ can be used as part of a traditional neuro cognitive examination and monitoring program. The baseline Dynavision D2 ™ results can be compared to repeat tests to see if deficits are present. Further, programs designed to assess multiple brain cognitive parameters can be performed in just a few minutes. The three tests assess: eye-hand coordination while multi-tasking, memory and cognition, cognition and executive functions. Observing the subject and noting their scores allows for an assessment of their concussion status. One of the strengths of the Dynavision D2 ™ is that it has an established cadre of programs that anyone can use. These programs can be used for rehab, prehab and diagnostics. Plus it has a relatively intuitive program option that allows more experienced practitioners and ADT trained individuals to design their own programs to meet their needs. This means that the Dynavision is a highly flexible and adaptable platform. Every person who works with athletes, injured athletes and neuro patients knows that each person is different and unique; training and rehab methods need to be personalized. Fortunately the Dynavision allows us to customize the programs to address the needs of the patient. There are numerous anecdotes where a patient who expresses a deficit that he/she is having to a rehab person who can write and try a program to help that patient during that very rehab session. One of my patients at the concussion clinic in theUniversityofCincinnatiwas injured in a wind storm. During her baseline neuro exam, we utilized the tests mentioned above and additional tests based on her specific results. The D2 was able to demonstrate the patient was unable to multi-task, making numerous math errors on simple 1 digit additions. In addition, based on a general neuro exam, the patient exhibited deficiencies in ocular motor, memory and executive function. This patient specifically benefited from the D2 as part of her neuro exam because the D2 gave measurable, unbiased results. The results of the exam were utilized to incorporate D2 training into her rehab program to improve binocularity, reaction time, multi-tasking, and cognition skills. In my opinion, without using the D2, this patient’s rehab would not have been as successful and it could have been possible to overlook subtle deficiencies that D2’s measurable results are able to track. In the center of the Dynavision D2 ™ is a tachistoscope; or small computer screen. This screen is used in several of the evaluation and rehabilitation methods. It adds tremendous flexibility to the system because it can be used to add tasks to what the subject is required to do. With the tachistoscope the patient can now be required to do a hand-eye task as well as reading or other task from the screen. This allows for multitasking to be performed and adds to the flexibility and strength of the Dynavision D2 ™ as a tool to manage the concussion patient. Repeating the evaluations on the Dynavision D2 ™ can be used as part of quantitative monitoring of the subjects as they progress through concussion rehab. The Dynavision produces reliable numbers that reflect the subjects’ performance or highlights deficiencies. When the Dynavision D2 ™ is used as part of the rehab training it becomes a cornerstone in the patient’s care and the patient can see, based on their own results, how well they are doing. Rehabilitation methods can be tailored to the needs of the patient and with many years of experience from the stroke and brain injury literature there are numerous options for the Dynavision D2 ™ to aid in a concussion rehabilitation program. About the Authors: Dr. Clark is a certified athletic trainer, professor of neurology and member of the concussion management team in the University of Cincinnati. He is an expert in complications post acquired brain injury and has published several texts and over 100 scientific articles. Mrs. Umberg is a former concussion patient and the patient referred to in this Case Study. Having used Dynavision as part of her rehab program she has since become a patient advocate and team member in the concussion management team in the University of Cincinnati and Dynavision Trainer. Disclaimer; the statements made are not screened or approved by the FDA. Source: Joseph F. Clark and Jennifer A. Umberg Department of Neurology, University of Cincinnati, Cincinnati Ohio; 45267-0536. Corresponding author: Joseph F. Clark, Professor of Neurology, joseph.clark@uc.edu.

Starting in 2012, helmet reconditioners will no longer accept helmets 10 years or older. Leagues that have depended on reconditioning their helmets every year and cannot afford replacement gear will be most affected. Although helmets do not prevent concussions, most experts agree that newer ones are preferable to used, and an older, unreconditioned helmet might increase the risk of injury. Many leagues ask their booster clubs for assistance with fundraising as this issue has now reached a critical phase. Limited grants for replacement helmets by leading manufacturers are now available for eligible youth leagues in several areas around the country. Applications are now being accepted for youth football programs seeking to replace their league's helmets before the start of the 2012 season. The Centers for Disease Control and Prevention, USA Football and partnering organizations have introduced a helmet replacement program for youth in underserved communities. It is estimated the program will provide almost 13,000 new helmets to athletes in low-income communities beginning in July 2012. To qualify a league must meet the following criteria: - Operate a youth football league (no middle or high school programs) - Live in one of the following areas: Cleveland, New Orleans, New York, or the San Francisco Bay area - Serve an economically disadvantaged area The application process requires registration at USA Football, the governing body for youth football under the NFL. The application is accessible only after viewing a concussion awareness video and pledging to utilize USA Football's resources to educate members of your league before the 2012 season. A visit from an official to verify the ages and number of helmets exceeding 10 years of age in your inventory will occur by mid-June, with new helmets arriving prior to the beginning of the 2012 season. Participating helmet manufacturers include Rawlings, Xenith, Riddell and Schutt. Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

The brain appears to be wired more like the checkerboard streets of New York City than the curvy lanes of Columbia, Md., suggests a new brain imaging study. The most detailed images, to date, reveal a pervasive 3D grid structure with no diagonals, say scientists funded by the National Institutes of Health. “Far from being just a tangle of wires, the brain’s connections turn out to be more like ribbon cables -- folding 2D sheets of parallel neuronal fibers that cross paths at right angles, like the warp and weft of a fabric,” explained Van Wedeen, M.D., of Massachusetts General Hospital (MGH), A.A. Martinos Center for Biomedical Imaging and the Harvard Medical School. “This grid structure is continuous and consistent at all scales and across humans and other primate species." Wedeen and colleagues report new evidence of the brain’s elegant simplicity March 30, 2012 in the journal Science. The study was funded, in part, by the NIH’s National Institute of Mental Health (NIMH), the Human Connectome Project of the NIH Blueprint for Neuroscience Research, and other NIH components. “Getting a high resolution wiring diagram of our brains is a landmark in human neuroanatomy,” said NIMH Director Thomas R. Insel, M.D. “This new technology may reveal individual differences in brain connections that could aid diagnosis and treatment of brain disorders.” Knowledge gained from the study helped shape design specifications for the most powerful brain scanner of its kind, which was installed at MGH’s Martinos Center last fall. The new Connectom diffusion magnetic resonance imaging (MRI) scanner can visualize the networks of crisscrossing fibers – by which different parts of the brain communicate with each other – in 10-fold higher detail than conventional scanners, said Wedeen. “This one-of-a-kind instrument is bringing into sharper focus an astonishingly simple architecture that makes sense in light of how the brain grows,” he explained. “The wiring of the mature brain appears to mirror three primal pathways established in embryonic development.” As the brain gets wired up in early development, its connections form along perpendicular pathways, running horizontally, vertically and transversely. This grid structure appears to guide connectivity like lane markers on a highway, which would limit options for growing nerve fibers to change direction during development. If they can turn in just four directions: left, right, up or down, this may enforce a more efficient, orderly way for the fibers to find their proper connections – and for the structure to adapt through evolution, suggest the researchers. Obtaining detailed images of these pathways in human brain has long eluded researchers, in part, because the human cortex, or outer mantle, develops many folds, nooks and crannies that obscure the structure of its connections. Although studies using chemical tracers in neural tracts of animal brains yielded hints of a grid structure, such invasive techniques could not be used in humans. Wedeen’s team is part of a Human Connectome Project Harvard/MGH-UCLA consortiumExternal Link: Please review our disclaimer. that is optimizing MRI technology to more accurately to image the pathways. In diffusion imaging, the scanner detects movement of water inside the fibers to reveal their locations. A high resolution technique called diffusion spectrum imaging (DSI) makes it possible to see the different orientations of multiple fibers that cross at a single location – the key to seeing the grid structure. In the current study, researchers performed DSI scans on postmortem brains of four types of monkeys – rhesus, owl, marmoset and galago – and in living humans. They saw the same 2D sheet structure containing parallel fibers crossing paths everywhere in all of the brains – even in local path neighborhoods. The grid structure of cortex pathways was continuous with those of lower brain structures, including memory and emotion centers. The more complex human and rhesus brains showed more differentiation between pathways than simpler species. Among immediate implications, the findings suggest a simplifying framework for understanding the brain’s structure, pathways and connectivity. The technology used in the current study was able to see only about 25 percent of the grid structure in human brain. It was only apparent in large central circuitry, not in outlying areas where the folding obscures it. But lessons learned were incorporated into the design of the newly installed Connectom scanner, which can see 75 percent of it, according to Wedeen. Much as a telescope with a larger mirror or lens provides a clearer image, the new scanner markedly boosts resolving power by magnifying magnetic fields with magnetically stronger copper coils, called gradients. Gradients make it possible to vary the magnetic field and get a precise fix on locations in the brain. The Connectom scanner’s gradients are seven times stronger than those of conventional scanners. Scans that would have previously taken hours – and, thus would have been impractical with living human subjects – can now be performed in minutes. “Before, we had just driving directions. Now, we have a map showing how all the highways and byways are interconnected,” said Wedeen. “Brain wiring is not like the wiring in your basement, where it just needs to connect the right endpoints. Rather, the grid is the language of the brain and wiring and re-wiring work by modifying it.” Curvature in this DSI image of a whole human brain turns out to be folding of 2D sheets of parallel neuronal fibers that cross paths at right angles. This picture came from the new Connectom scanner.Source: Van Wedeen, M.D., Martinos Center and Dept. of Radiology, Massachusetts General Hospital and Harvard University Medical School Reference Wedeen VJ, Rosene DL, Ruopeng W, Guangping D, Mortazavi F, Hagmann P, Kass JH, Tseng W-YI. The Geometric Structure of the Brain Fiber Pathways: A Continuous Orthogonal Grid. March 30, 2012 Science. ### The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit the NIMH website. The NIH Blueprint for Neuroscience Research is a cooperative effort among the NIH Office of the Director and the 15 NIH Institutes and Centers that support research on the nervous system. By pooling resources and expertise, the Blueprint supports transformative neuroscience research, and the development of new tools, training opportunities, and other resources to assist neuroscientists. About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit the NIH website. Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

The first of three private screenings was held in Chicago on May 15th for "Head Games," a documentary on the sports concussion crisis. From acclaimed director Steve James (Hoop Dreams, The Interrupters) and award-winning producer Bruce Sheridan, Head Games takes a deeper look at the devastating and long-term effects of concussions in all sports. Inspired by events from the book Head Games written by Christopher Nowinski, the film offers eye-opening insight and cutting-edge science on head trauma from the nation’s leading medical experts. Additional screenings will be held June 6 at the Boston University School of Medicine Albany Street Auditorium and June 7 in Philadelphia at the Translational Research Center (TRC) Rubenstein Auditorium. Watch the trailer Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org

"Short term memory's not good," Jim McMahon, former Chicago Bears quarterback and two-time Super Bowl champion tells ESPN. "I won't remember a lot about this interview in about 10 minutes." McMahon and his girlfriend give a rare look inside the daily struggles he says were a result of repeated blows to the head incurred during his 15-year NFL career. McMahon and hundreds of other former NFL players are suing the league for allegedly concealing information about the risk of concussions. ESPN Outside the Lines -- Taking Its Toll (8:12)(video) The 52-year-old McMahon says he suffered three documented concussions during his career, impacts significant enough that he was unaware of his surroundings. Now he has good days and bad days according to his girlfriend, Laurie Navon, who has programmed the GPS in his car with their home address in case he gets lost. He repeatedly purchases the same books on his e-reader. The Chicago Bears selected McMahon in the first-round of the 1982 NFL Draft where he won the starting quarterback position as a rookie. McMahon led the Bears to a Super Bowl victory in 1985, where he became the first quarterback in the championship's history to rush for two touchdowns. He returned to win the Super Bowl a second time as a Green Bay Packer in 1996. On Oct. 12, 1988 the Chicago Tribune reported that McMahon had been evaluated by an athletic trainer on the sideline who said, "He had a concussion, but it cleared by halftime." The NFL has much stricter policies and standards regarding head injury today, as more information on concussions has become available. Source: ESPN: Outside the Lines -- Taking Its Toll March 18, 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

It is not yet known why girls suffer concussions at a higher rate than boys. The most prevalent theories range from lesser neck and upper body strength, to better reporting among females, to hormonal differences. Researchers at Emory University in Atlanta are currently in the third phase of a clinical trial designed to determine if the hormone progesterone, normally associated with female reproductive processes, can protect damaged neurons. Administered within four hours of the injury and lasting for three days, results of the treatment have been positive so far. Although catastrophic injuries in sports are rare, the question regarding applicability of a related treatment for concussion remains open. Pilot study highlighted efficacy Every 15 seconds, someone in the United States sustains a significant traumatic brain injury. Approximately 2 million adults and children in the United States suffer from traumatic brain injuries each year - leading to 50,000 deaths and 80,000 new cases of long-term disability, according to the Centers for Disease Control and Prevention. Despite the enormity of the problem, scientists have failed to identify effective medications to improve outcomes following a traumatic brain injury. Emory researchers, however, concluded in an earlier pilot clinical trial that giving progesterone to trauma victims shortly following brain injury appears to be safe and may reduce the risk of death and long-term disability. Their previous three-year study, called ProTECT I (Progesterone for Traumatic brain injury--Experimental Clinical Treatment), enrolled 100 participants at Grady Memorial Hospital. It was designed to evaluate whether progesterone can be administered intravenously in a safe and reliable way. "We found evidence that progesterone is not only safe for use in patients suffering from traumatic brain injuries," says Wright. "We also found a 50 percent reduction in mortality in those patients treated with progesterone. Even though this was a small pilot study, we found signs that progesterone improved functional outcomes and reduced disability in patients with moderate brain injury. "By expanding our test sites to 17 major trauma centers across 15 states and enrolling more than 1,000 patients, we hope to confirm these preliminary findings and determine if progesterone benefits victims of acute traumatic brain injury," says Wright. Progesterone common in males and females Progesterone is naturally present in small but measurable amounts in the brains of males and females. Human brain tissue is loaded with progesterone receptors. Laboratory studies suggest that progesterone is critical for the normal development of neurons in the brain and exerts protective effects on damaged brain tissue. Donald G. Stein, PhD, Asa G. Candler Professor of Emergency Medicine, Emory School of Medicine, and director of Emory's Department of Emergency Medicine Brain Research Laboratory, pioneered discoveries regarding the effect of progesterone following traumatic brain injury - first discovering the neuro-protective properties of progesterone in the laboratory more than 25 years ago. "The results that we are now seeing, and hope to continue validating, are an incredible and gratifying reward for more than 25 years of concentrated research," says Stein. "My work first started when I began to notice evidence that women tended to respond to treatment and recover better than men after suffering from brain injury and stroke. Many people do not realize that it's not just a female hormone; both men and women produce progesterone directly in the brain, as well as other tissue. "Ultimately, we learned that progesterone basically does in brain injuries what it also does during fetal development - protect cells and tissue," says Stein. "To now witness the translation of this laboratory research into a treatment that may have life-saving benefits is breathtaking." Source: A Hormonal Remedy for Brain Injuries is Explored --The New York Times -- June 21, 2012 Atlanta To Serve as National Epicenter for Promising Phase III Brain Injury Treatment Trial - Emory University Photo courtesy of (c) 2008 Eddy Grady@creativecommons.com Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

COLUMBUS, Ohio – There is no magic test to determine when an athlete is ready to get back into the game after they have suffered a head injury. Researchers have started using an interactive video game, a tool many athletes are already using in rehabilitation, to test balance for concussion assessment and management. The reliability of the video game for assessing athletes’ concussions has not been confirmed, but a study by a sports medicine researcher from The Ohio State University Wexner Medical Center may provide insight to the use of the Nintendo’s Wii Fit for concussion management. Team athletic trainers often determine whether an athlete has a concussion based on their physical examination, cognitive ability, self-report of symptoms and balance. "Student athletes love it because we have incorporated fun into their rehabilitation and concussion assessment," said Tamerah Hunt, director of research at the OSU’s Sports Medicine Concussion Program. “For many school districts, it is an affordable option and can be portable, making it convenient for sideline testing and travel with the team for away games.” Researchers from Ohio State and the University of Maryland are conducting baseline testing for concussion management in collegiate athletes, and will soon do the same among high-school athletes. Recent concussion guidelines suggest postural control is an important part of the assessment process, which makes balance an important piece of information in determining recovery from a head injury. “It’s not the perfect system, but can be considered as an option to provide basic objective information about balance,” said Hunt, whose previous research includes examining concussion recovery patterns among high school students in several states. “It’s another tool to have in our toolkit because determining when an athlete has recovered can be subjective,” Hunt admits. “Athletes are more likely to engage with a video game than to take another boring concussion test or admit they are still hurt,” said Hunt. “We currently base much of our assessment on an athlete telling us about their symptoms. The video game allows us to broadly analyze center of gravity, to help us be more objective.” Athletes participate in three different yoga poses as demonstrated on the Wii Fit game and are given a score which determines how well the athlete maintained center of balance. Baseline testing provides athletic trainers with an idea of how an athlete normally functions. If an athlete suffers a head injury at a later date, the athletic trainer can assess the balance of the athlete compared to their normal ability. According to Hunt, an athletic trainer must obtain the baseline measures to compare the athlete to themselves because everyone performs differently. Preliminary data suggests a moderate correlation to current methods used in concussion assessment, ranging from 0.75-0.82, depending on the stance. “Additional studies need to be performed to determine the long-term reliability of the measures and other factors associated with test scores, such as fatigue,” said Hunt. This is just the beginning of studies using alternative measures of balance assessment like the Wii Fit for concussion management. The National Collegiate Athletic Association concussion guidelines support using the video game as a postural assessment tool. It is not yet approved as a medical device by the Food and Drug Administration. Source: Ohio State University Wexner Medical Center -- May 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org